crossing96/oncoscreening huggingface dataset:
Prostate sparing radical cystectomy and neobladder: institutional long-standing qualified consideration.	OBJECTIVES: To balance the extended functional urinary voiding and morbidity outcomes amid Ileal W and Y-shaped contrasted to spherical ileocoecal (IC) orthotopic bladders subsequent prostate-sparing radical cystectomy (PRC) versus standard radical cystoprostatectomy (RC). MATERIAL AND METHODS: Two hundred eight male bladder cancer patients were grouped into 98 RC followed by 43-W, 31-Y, and 23-IC in comparison to 110 PRC followed by 35-W, 37-Y, and 38-IC. The functional voiding outcomes were determined by detailed patients' interview and urodynamic studies (UDS). RESULTS: Twenty-four hour pad-free continence for PRC at the 6th month was (37, 25, and 36%) as regards W, Y, and IC in that order, improved to (51, 44, and 51%) at the 12th month and (68, 70, 73%) at the 5th year. Nocturnal continence at the 12th month was (60, 56 and 59%). After 73 months median surveillance, day-time control was 90% equal for the 3 pouch configurations. RC patients faced inferior continence rates exclusively during nocturnal time. Urethral pressures started higher for PRC and increased over time, resulting in diminution of stress frequency. Delayed pouch morbidities were 41% for W vs. 22.4% and 25% among Y and IC series. Urethral recurrences were non-existent in both groups without atypical or metaplastic changes. Mucosal pattern persisted in 60% while muscular coat atrophied in 83% of ileal and 40% of colon walls. CONCLUSION: Voiding control parameters for PRC were significantly superior. Though early continence is in favor of W pouches, delayed observation showed equivalent Y and IC results besides least delayed pouch-related morbidities for IC.	bladder
Bladder carcinoma in a bladder diverticulum: a case report.	BACKGROUND: Bladder carcinoma arising within a bladder diverticulum is a rare but significant clinical entity. Owing to the absence of a muscularis propria in the diverticular wall, these tumors have a higher propensity for early invasion and present unique challenges in diagnosis and management. The most common histology is urothelial carcinoma, though squamous cell carcinoma and adenocarcinoma may also occur. Treatment options vary based on patient condition, tumor stage, with surgical excision being the primary modality. This paper presents a case of bladder carcinoma in a diverticulum treated by transurethral resection owing to advanced age and comorbidities, followed by a discussion of diagnostic and management strategies. CASE PRESENTATION: A 87-year-old Caucasian non-Hispanic male with a history of benign prostatic hyperplasia with painless gross hematuria and irritative voiding symptoms. Imaging studies, including Ultrasound and computed tomography urography revealed a bladder diverticulum containing a soft tissue mass. Cystoscopy biopsy confirmed noninvasive low-grade papillary urothelial carcinoma with benign muscularis propria. Owing to the patients age and concomitant medical conditions, he underwent transurethral resection, and pathology confirmed pT1 disease. The postoperative course was uneventful, and follow-up cystoscopy at 6 months showed local recurrence. CONCLUSION: Bladder carcinoma in a diverticulum requires a high index of suspicion for timely diagnosis. Given the structural limitations of diverticular walls, transurethral resection may be inadequate, necessitating surgical excision for definitive management. Early detection and a multidisciplinary approach are essential to improving patient outcomes. Close follow-up is imperative due to the increased risk of recurrence and progression.	bladder
Matrix stiffness maintains bladder cancer stemness via integrin-nuclear skeleton axis.	Tumors have a unique niche system that plays an important role in their occurrence and development. At present, there is increasing interest in the biomechanical properties of niches. The increased stemness of cancer cells is closely related to bladder cancer progression and recurrence. However, how biomechanical properties in the niche regulate bladder cancer stemness remains unclear. Here, we show that as bladder cancer progresses, matrix stiffness increases, and tumor stemness increases. Mechanistically, high matrix stiffness mediates β-catenin nuclear translocation by increasing the nuclear pore size. On the other hand, it promotes the expression of the nuclear cytoskeletal protein Lamin A/C, inhibits the nuclear export of β-catenin, and finally, it upregulates the Wnt pathway to increase the stemness of cancer cells. These findings reveal a role for matrix stiffness in the regulation of stemness in bladder cancer cells and suggest that targeting matrix stiffness may be an effective strategy to delay bladder cancer progression.	bladder
Diagnostic performance of Cxbladder Triage Plus for the identification and stratification of patients at risk for urothelial carcinoma: The multicenter, prospective, observational DRIVE study.	INTRODUCTION: Cxbladder Triage Plus provides risk stratification for the presence or absence of urothelial carcinoma (UC) in patients presenting with hematuria. Triage Plus is a multimodal urinary biomarker test that detects 5 UC-associated mRNAs and 6 DNA single-nucleotide variants from fibroblast growth factor receptor 3 and telomerase reverse transcriptase genes. The aim of this study was to provide external validation of the diagnostic performance of Triage Plus for evaluation of UC in a veterans affairs (VA) population with hematuria. METHODS: The multicenter, prospective, observational DRIVE study enrolled adults (≥18 years) from VA clinics presenting with gross hematuria or microhematuria. Midstream urine samples were tested with Triage Plus and with Cxbladder Triage and Detect. The primary objective was external clinical validation of the diagnostic performance of Triage Plus versus white light cystoscopy and pathological confirmation as the standard for primary UC diagnosis. RESULTS: Of 615 patients with hematuria (278 with gross hematuria, 337 with microhematuria), 48 (7.8%) had histologically confirmed UC and 587 (95.4%) had available Triage Plus results. Compared with cystoscopy, Triage Plus had sensitivity of 94% (95% confidence interval 83%-99%), specificity of 77% (73%-80%), positive predictive value (PPV) of 26% (20%-34%), negative predictive value (NPV) of 99.3% (97.3%-99.9%), and a test-negative rate (TNR) of 71% (67%-75%). Triage Plus had higher specificity, PPV, and TNR than Triage, and higher sensitivity and NPV than Detect. CONCLUSIONS: Triage Plus demonstrated clinical validity in veteran patients with hematuria, with improved sensitivity and specificity compared with earlier assays.	bladder
The changing landscape of urinary diversion post cystectomy: A 15-year analysis of the NSQIP database.	BACKGROUND: Radical cystectomy (RC) with urinary diversion is the standard of care for high-risk non-muscle-invasive and muscle-invasive bladder cancer. While continent urinary diversions offer potential quality-of-life benefits, their adoption over time remains poorly defined. OBJECTIVE: To evaluate national trends in the use of continent versus incontinent urinary diversion following RC and identify demographic and clinical factors associated with diversion type. METHODS: We analyzed data from the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) from 2008 to 2022. Patients undergoing RC with urinary diversion were identified using CPT codes. Diversion type, temporal trends, and associated demographic and clinical variables were assessed using descriptive statistics and multivariable Firth logistic regression models. RESULTS: Among 26,587 patients, 85.1% received incontinent diversion and 14.9% received continent diversion. The use of continent diversion declined significantly over time, particularly among males, patients under 75 years old, and White patients. No significant trends were observed among female, Black or Asian patients. CONCLUSION: Continent urinary diversions have declined over the past decade despite surgical advancements, with notable variation by age, sex, and race. These findings highlight the influence of clinical and sociodemographic factors on diversion selection. The extent to which these findings reflect practice patterns beyond NSQIP remains uncertain.	bladder
Dual-Spherical Multifunctional Nanomotors for Intravesical Bladder Cancer Therapy.	BACKGROUND: Conventional intravesical chemotherapy for bladder cancer has shown limited clinical efficacy. To overcome this challenge, self-propelled nanomotors, including urease-modified nanomotors, have been developed. These nanomotors enhance drug diffusion in urine, offering advantages over traditional drugs and passive nanoparticles. However, a key issue remains: the inability to maintain long-term urease activity. METHODS: Nanozymes, glucose oxidase, and urease are synthesized into a three-enzyme nanomotors via biomineralization, serving as a power source. Cell membrane nanoparticles loaded with gemcitabine were combined with three-enzyme nanomotors to form dual-spherical nanomotors. TEM, DLS, and analyses of urease/glucose oxidase activity and nanomotor trajectories confirmed successful nanomotor fabrication. These nanomotors can regulate tumor cell glucose metabolism and release gemcitabine upon cellular entry, achieving a dual anticancer effect. RESULTS: Nanomotors synthesized through biomineralization methods exhibit the ability to retain long-term activity. After intravesical instillation, urease-containing nanomotors decomposed urea to produce carbon dioxide and ammonia, propelling rapid nanoparticle movement for deep bladder wall penetration. The homing ability of the tumor membrane-coated nanoparticles enhanced nanomotor accumulation in tumor cells. Subsequently, the nanomotors release Gox and gemcitabine, which significantly inhibit tumor progression. CONCLUSION: This innovative strategy utilizes gemcitabine - loaded nanomotors to penetrate the mucus layer and target tumors, inducing cell death for the treatment of bladder cancer.	bladder
An Organoid Biosensing Platform for Personalized Prognosis of Bladder Cancer.	Bladder cancer is a common malignancy with high rates of recurrence and progression. Chemotherapy is employed at various stages of treatment to improve patient outcomes and survival; however, it is sometimes ineffective and often associated with significant side effects. Moreover, growing evidence suggests that chemotherapy may paradoxically enhance tumor invasiveness and metastatic potential in certain cancer types. These concerns underscore the need to better understand the impact of chemotherapy and to develop personalized prognostic strategies for managing bladder cancer. Here, we present an organoid biosensing platform designed to evaluate chemotherapy-induced effects in a patient-specific manner. Freshly isolated tumor organoids and self-assembled microtumors derived from transurethral resection of bladder tumors are cultured within a tumor-on-gel biomimetic microenvironment. By integrating live single cell nanobiosensors with 3D time-lapse microscopy, the platform enables real-time detection of molecular biomarkers and rapid assessment of tumor invasiveness. We demonstrate the platform's capability to evaluate cisplatin-induced invasion in bladder cancer organoids at the individual patient level. These findings highlight the potential of this organoid biosensing system to investigate patient-specific risks of chemotherapy-induced invasion and to guide more personalized approaches to bladder cancer treatment.	bladder
A Systematic Review and Meta-Analysis of the Effectiveness and Safety of Immune Checkpoint Inhibitors in Patients With BCG-Unresponsive Non-Muscle-Invasive Bladder Cancer.	The primary cancer of the urinary system is bladder cancer, which includes 2 subtypes: muscle-invasive bladder cancer (MIBC) and non-muscle-invasive bladder cancer (NMIBC). Intravesical Bacillus Calmette-Guérin (BCG) therapy remains the gold standard for treating individuals with high-risk NMIBC. However, disease development and recurrence pose serious clinical problems. This study aims to evaluate the safety and efficacy of immune checkpoint inhibitors (ICIs) as innovative therapeutic approaches for patients with BCG-unresponsive NMIBC. We conducted this study according to the PRISMA guidelines. We systematically reviewed clinical trials that evaluated ICIs as a treatment for BCG-unresponsive NMIBC and reported predefined efficacy and safety outcomes. We synthesized data using R software and evaluated the risk of bias using the ROBINS-I tool. Nine studies (488 patients) were included in the review, of which 6 were pooled in the meta-analysis. Following ICI therapy, the complete response (CR) rates were 36% at 3 months, 25% at 6 months, and 18% at twelve months. Across all studies, 14% of patients had a radical cystectomy (RC), with the lowest rates occurring in patients receiving atezolizumab. Treatment-related adverse events (TrAEs) were common, occurring in 15% of patients at grades 3 to 5 and 67% of patients at grades 1 to 2. Adverse events related to the immune system (IrAEs) were noted in 6% of individuals with grades (3-5) and 22% of patients with (grades 1-2). Serious adverse events occurred in 15% of patients overall; the atezolizumab group had a greater incidence (21%) than the pembrolizumab group (11%). Immune checkpoint inhibitors have shown encouraging effectiveness and safety in treating BCG-unresponsive NMIBC. However, the observed variability in therapeutic response and adverse events highlights the necessity for large-scale RCTs to clarify long-term efficacy and inform patient selection for ICI-based therapies.	bladder
Second opinions and pathological review impact the clinical management of patients with muscle-invasive bladder cancer.	PURPOSE: Studies evaluating inter-institutional discrepancies in muscle-invasive bladder cancer diagnosis, particularly when radical cystectomy is recommended, are scarce. In this study, we aimed to examine the inter-institutional concordance rate of pathological stages in patients diagnosed with muscle-invasive bladder cancer. METHODS: We reviewed tissue samples from patients pathologically diagnosed with muscle-invasive bladder cancer at other hospitals who subsequently sought a second opinion at our hospital between January 1, 2013 and December 31, 2023. Data were acquired retrospectively by retrieving clinical data from medical records. We investigated the inter-institutional concordance rate of pathological stages assigned to each patient and examined the tumor characteristics and prognoses of patients with pathological stage discrepancies. RESULTS: Of the 170 patients evaluated, 22 (12.9%) were downstaged upon pathological examination at our hospital. The tumor characteristics of stage discrepancy cases were small tumor size, solitary lesions, and vesical imaging reporting data system score < 3. Eleven patients were treated for non-muscle-invasive bladder cancer based on the re-evaluation findings. Eight patients had no evidence of disease, two patients had Ta bladder recurrence, and one patient had lung metastasis despite no bladder recurrence. CONCLUSION: This study highlights the importance of pathological re-evaluation of patients diagnosed with muscle-invasive bladder cancer. The significant discrepancy rate and its impact on the treatment decisions are noteworthy. Standardization of diagnostic practices is essential to mitigate variability among pathologists and facilities and to ensure optimal care for patients with muscle-invasive bladder cancer.	bladder
Tetra-modality bladder preservation with avelumab for muscle-invasive urothelial cancer: a phase II trial (TRIUMPH-B01).	BACKGROUND/AIMS: Muscle-invasive bladder cancer (MIBC) has a 5-year survival rate of 40-60% following traditional treatment with neoadjuvant chemotherapy (NAC) and radical cystectomy (RC), which significantly impacts quality of life. Bladder preservation strategies, including maximal transurethral resection of the bladder tumor (TURBT), NAC, and radiation therapy, offer similar survival rates with better quality of life. Immune checkpoint inhibitors like avelumab show potential benefits when combined with bladder preservation modalities. This phase II randomized, non-comparative, double-arm, open-label, multicenter trial evaluates the efficacy and safety of two tetra-modality bladder preservation strategies in MIBC patients (T2-T4N0M0). The primary endpoint is the 2-year proportion of bladder-preserved participants. Secondary endpoints include response rates post-induction, quality of life, and safety evaluations. METHODS: Eighty participants will be randomized 1:1 into Arm A or Arm B. All participants will first receive induction chemotherapy (DDMVAC or GC) combined with avelumab, followed by disease evaluation using imaging and TURBT. Those achieving a complete or near-complete response will proceed to hypofractionated radiation therapy (55 Grays in 20 fractions). After radiation, Arm A will receive maintenance avelumab for 1 year, while Arm B will follow a watch-and-wait approach. Non-responders in both arms will be referred for salvage RC. CLINICAL TRIAL REGISTRATION: NCT06686381 (ClinicalTrials.gov).	bladder
XGBoost-based urinary microbial signatures enable non-invasive diagnosis and prognosis for urothelial carcinoma.	BACKGROUND: Urothelial carcinoma (UC) is the most common malignant tumor of the urinary system, characterized by high incidence and recurrence rates, posing a serious threat to human health. While previous studies have linked urinary microbiota alterations to bladder cancer, little is known about the broader spectrum of UC subtypes or their clinical implications. To address this gap, we analyzed microbiota profiles across multiple UC subtypes, incorporating microbial network analyses and machine learning to establish diagnostic models and identify prognostic biomarkers. METHOD: A total of 112 subjects were enrolled for 16 S rDNA sequencing of clean-catch midstream urine samples, including 63 patients with bladder cancer (BCA), 29 with Upper Tract Urothelial Carcinoma (UTUC), 9 with renal pelvis cancer (RPC), and 40 healthy controls (HC). Microbial diversity, community networks, and clinical associations were analyzed. An XGBoost-based diagnostic model was developed with a 70/30 train-test split, cross-validation, and external validation. Model interpretability was assessed with the SHAP algorithm. RESULTS: UC groups showed elevated α-diversity versus HC, with consistent enrichment of Streptococcus and Clostridium. Microbial structure networks significantly differed in tumors. A urinary microbiota-based diagnostic model achieved high accuracy for BCA detection (AUC = 0.927), and Lachnospiraceae family members showed potential prognostic value. CONCLUSION: Our study illuminates the microbial profiles in the UC and suggests that urinary microbiota signatures represent promising non-invasive independent biomarker for the diagnosis and prognosis of UC.	bladder
Identification of biomarkers associated with mitophagy in bladder cancer.	"Bladder cancer (BLCA) is the most prevalent malignant tumor of the urinary system. Mitophagy is a selective form of autophagy that occurs within the mitochondria. The goal of this study was to determine mitophagy-related biomarkers associated with BLCA and to explore their underlying molecular mechanisms. CTSK, MTERF3, SRC, and CSNK2B were identified as biomarkers. A risk model classified BLCA patients into high-risk group (HRG) and low-risk group (LRG), with HRG patients exhibiting lower survival probabilities. The ""chemical carcinogenesis-DNA adducts"" and ""cytokine-cytokine receptor interaction"" signaling pathway were closely associated with HRG and LRG. TP53 had the highest mutation frequencies in the HRG and LRG, respectively. The two groups exhibited significant differences in 14 immune cells, including M2 macrophages. CTSK exhibited the strongest correlation with the naive B cells. A total of 135 drugs differed in sensitivity between HRG and LRG, including KU.55933. The identified regulatory network included ADAMTSL4-AS1-hsa-miR-149-5p-SRC. Expression analysis showed that CTSK was significantly downregulated in the BLCA group, while MTERF3, SRC, and CSNK2B were significantly upregulated. In conclusion, CTSK, MTERF3, SRC, and CSNK2B laid the foundation for targeted therapy in the treatment of BLCA."	bladder
Characterization of Ty21a immunostimulatory effects in the mouse bladder.	Intravesical treatment with Salmonella enterica Ty21a, an oral typhoid-fever vaccine, has shown therapeutic potential against bladder tumors mainly through local immune-cell recruitment, particularly CD8(+) T-cells. However, the mechanisms underlying its efficacy and the impact of bacterial formulation remain unclear. Here, we show that increased immune-cell infiltration was neither associated with modification in blood vessel density nor the generation of high endothelial venules, but rather with a transient increase in local vessel permeability, requiring live bacteria. Giving prior evidence that freshly harvested bacteria (Ty21a(FR)) were more efficient than lyophilized bacteria (Ty21a(LYO)), we tested both formulations intravesically in mice. Although, both similarly increased vascular permeability, Ty21a(FR) induced significantly greater immune-cell recruitment locally and more effective tumor regression in the orthotopic MB49 bladder cancer model. Chemokine analysis showed higher levels of C5a, CXCL2 and CXCL5 in Ty21a(FR)-treated bladders, however their receptors (C5aR, CXCR2) were barely detected on infiltrating T cells, precluding their direct involvement in T-cell recruitment. Instead, Ty21a(FR) increased C5aR(+) and C5aR(-)CD11b(high) myeloid cells, suggesting their indirect influence on T-cell recruitment. We hypothesized that LPS, a TLR4 agonist, from Salmonella, might be involved. Indeed, CD8(+) T-cell infiltration following Ty21a(FR) was significantly decreased in TLR4- and MyD88-KO mice. In contrast, myeloid-cell recruitment was only reduced in MyD88-KO mice, suggesting the involvement of TLR4-independent pathways in that process. This study is the first to identify Ty21a formulation-driven immunostimulatory differences in bladder cancer. Altogether, our data provide new insights into Ty21a's immunostimulatory mechanisms and highlight the importance of bacterial formulation for optimizing bladder cancer treatment.	bladder